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CT analysis of the anterior nasal airway based on the direction of nasal airflow in patients with nasal obstruction and trauma controls

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The anterior nose is the nasal segment with the highest resistance to airflow. In a hospital-based case–control study, we compared cross-sectional areas of the nasal cavities anterior to the piriform aperture determined by computed tomography (CT-CSA) in patients with nasal obstruction (cases) and unselected patients with trauma unrelated to the head and face (controls).

Methods

CT-CSA could be reproducibly identified at angles of 0o, 30°, 60°, and 90° to the nasal floor approximately perpendicular to the arcuate direction of nasal airflow using bony landmarks. CT-CSA were manually segmented and compared in cases and controls. In cases, we compared CT-CSA at 30° (CT-CSA30-narrow) with the minimum cross-sectional area determined by acoustic rhinometry (AR-MCA1-narrow), each on the narrower side.

Results

CT-CSA ranged from 7 to 250 mm2 with an average of 100 mm2 per nasal side. Side differences of the nasal airways indicating asymmetry of the nasal airways were greater in 40 cases than in 44 controls (p < 0.003). Moreover, bilateral CT-CSA were significantly smaller in cases than in controls (p < 0.001). CT-CSA30-narrow did not significantly correlate with AR-MCA1-narrow (r = 0.33; p = 0.07) and on average was 58% smaller than AR-MCA1-narrow.

Conclusions

Cross-sectional areas of the anterior nose perpendicular to the direction of nasal airflow, which is considered relevant in terms of flow physics, can be reliably measured using CT. Anterior nasal cavities in patients with nasal obstruction were more asymmetric and, as a whole, narrower than in controls, the latter of which is not corrected by routine septoplasty.

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Funding

The authors received no funding.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Aris I. Giotakis, Erik Mallien, Helen Heppt & Herbert Riechelmann

  2. Department of Radiology, Medical University of Innsbruck, 6020, Innsbruck, Austria

    Gerlig Widmann

  3. Department of Orthopaedics and Traumatology, Medical University of Innsbruck, 6020, Innsbruck, Austria

    Felix Riechelmann

Authors
  1. Aris I. Giotakis
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  2. Gerlig Widmann
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  3. Erik Mallien
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  4. Felix Riechelmann
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  5. Helen Heppt
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  6. Herbert Riechelmann
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Contributions

Conceptualization: HR; methodology: AIG, GW, FR, and HR; formal analysis and investigation: AIG, GW, EM, FR, HH, and HR; writing—original draft preparation: AIG, GW, EM, FR, HH, and HR; writing—review and editing: AIG, GW, EM, FR, HH, and HR; supervision: AIG and HR.

Corresponding author

Correspondence to Aris I. Giotakis.

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The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the ethics committee of the Medical University of Innsbruck (1261/2019).

Research involving human participants and/or animals

The authors ensure that the work described has been carried out in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans.

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Written informed consent was obtained from all subjects to use their anonymized data for scientific research.

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Giotakis, A.I., Widmann, G., Mallien, E. et al. CT analysis of the anterior nasal airway based on the direction of nasal airflow in patients with nasal obstruction and trauma controls. Eur Arch Otorhinolaryngol 280, 1765–1774 (2023). https://doi.org/10.1007/s00405-022-07703-1

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  • DOI: https://doi.org/10.1007/s00405-022-07703-1

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